AV nicking is key in the world of hypertension. These are the only capillaries you can see in the body.
Nicking is a classic sign of vessel disease. **
... [Show More] looks like vein stops on either side of the artery. - Ans-AV
Nicking
Small, odd shaped, yellow colored plaques are lipid deposits and indicate lipid metabolism problem. -
Ans-Xanthelasma
lower lid turned away from eye - Ans-Ectropion
lid turned inward - Ans-Entropion
drooping/sagging upper eyelid. Over the globe of the eye caused by problem in cranial nerve 3. - AnsPtosis:
crusting along eyelashes - Ans-Blepharitis:
infected - Ans-Acute purulent conjunctive:
abnormal growth of conjunctiva that extends over the cornea from the limbus. Overexposure to
ultraviolet rays - Ans-Pterygium:
lipids deposited in the periphery of the cornea - Ans-Arcus senilis:
those lipids in a complete circle - Ans-Cornal arcus senilis:
bright red blood in a sharply defined area. Sometimes present PG and labor resolve on own. - AnsSubconjuctival hemorrhage
red, cobblestone caused by allergic reaction - Ans-Erythema
small discrete spots that are slightly more yellow than the retina. With time they enlarge, aging but can
be precursor for senile macular degeneration. If they are increasing in number and color intensity use an
Amsler grid to eval central vision. - Ans-Drusen bodies
glaucoma - Ans-Cupping of optic disc
hypertension. Infarcts of retina - Ans-cotton wool spots
diabetes - Ans-cotton wool spots and hemorrhage
cataracts- risk factors
family hx, steroid med use, UV light, smoking cigs, DM, aging. - Ans-Opacities blocking red reflex
like a curtain or shadow has come down on part of my visual field. - Ans-partial retinal detachment
Pupils equal reactive to light not the same size - Ans-anisocoria
Flame- nerve layer fibers blood spreads parallel to fibers
Round- in deeper layers darker color
Dot- microaneurysm- diabetic retinopathy
At disc margin- poorly controlled/undiagnosed glaucoma - Ans-Hemorrhages
crossed eye. exotropic is outward toward midline. Esotropic is inward toward the nose. - Ans-Strabismus
20/200 - Ans-legal blindness
cranial nerve II
Blurry- problem with visual acuity or dbl vision/diplopia? Monocular diplopia is a optical prob. Binocular
is alignment. - Ans-VISUAL ACUITY-
Snellen chart cover one eye smallest line for fraction. Cover other eye. - Ans-Distance visionhold card 35cm from eye smallest line. Cover one eye at a time. - Ans-Near visionconfrontation test. Cover each eye in turn. You wiggle fingers into the center . pt says I see. - AnsPeripheral visionrefer to eye specialist if there is a two line difference in the visual acuity of different eyes. - Ans-Pediatric
pt
size, hair texture, extension beyond eye. - Ans-Inspect eyebrows for:
:
:
:
: .
:
edema, puffiness, sagging tissue - Ans-Inspect orbital area for
spasms=hyperthyroid, ability open wide and close. Redness, swelling, flakes. Do eyelashes curve in?
Ptosis? Eversion-ectropion ot Inversion-entropion - Ans-Inspect eyelids for
nodules - Ans-Palpate eyelids for
very firm: glaucoma, hyperthyroid, retrobulbar tumor - Ans-Palpate eye
clear? Red? Swelling? Exudate? Hemorrhage? pterygium ? Only peel up and down if foreign body
present. - Ans-Inspect conjunctivae
shine light tangentially to assess clarity. Should be clear. Corneal arc, circle may be hyperlipidemia - AnsExamine Cornea:
***
- cranial nerve 5/V. touch cotton to eye they need to blink. - Ans-Corneal sensitivity
if the cornea is clear and even in contour - Ans-Look at the eye from the far sideways position to see
1. inspect iris for being clearly visible and same color
2. Observe pupil shape and size
3. ***Test pupil response to light- direct and consensually- simultaneous constriction. Shine in one eyeconstrict in both.
4. Perform swinging flashlight test. Shine one a=eye and then go rapidly to the next. If second eye
doesn't constrict afferent pupil defect/optic nerve disease.
5. ***Accommodation- nerve IV. look distant object then focus object 10 cm from nose. Pupil should
constrict.
6. Nystagmus in book - Ans-Assess iris and pupil- 5 characteristics
Tear duct in the nasal corner of the eye - Ans-medial canthus.
plaque dark slate gray pigment. Not disease, just note. - Ans-Senile hyaline
A. CN 3-III-oculomotor, 4-IV-trochlear, 6-VI-abducens (lateral eye muscle moves)
B. Cardinal gaze
Up and down
Corneal light reflex-pt look nearby object, shine light nasal bridge, eyes should converge and reflect
light symmetrically
if this reflex unbalanced, perform cover-uncover test - Ans-A. Extraocular muscles there are 6 work with
B. 4 techniques:
Inspect interior eye:
Red reflex-look for opacities that look like black densities
Fundus- an easy way to find your way around the fundus is to Follow the branching of the blood vessels
that always branch away from the optic disc. Pigment-yellow or reddish pink, varies and can be darker
with skin color.
Retinal vessels- note pulsations abnormalities where arty and veins cross. ***AV nicking- looks like vein
stops on either side of an artery.
***Optic disc located by following a vessel centrally toward the midline of the head. Vessels nearer the
disc are directionally towards the nose, larger, less branching. Nasal region of the globe.
Macula- lighter dot surrounded by avascular area. 2 disc diameters temporal to disc. - AnsOpthalmoscopic exam
smell reception and interpretation
You have one nose on your face - Ans-Olfactory
visual acuity and visual fields
You have 2 eyes the optometrists uses the the Snellen chart to see if you need new opticals - Ans-(II):
Optic
raise eyelids, most extraocular movements, pupillary constriction, change lens shape - Ans-(III):
Oculomotor
downward, inward eye movement
Trochlear rhymes with the number 4
look down and towards the middle of the floor - Ans-(IV): Trochlear
jaw opening and clenching, chewing, and mastication, sensation to cornea, iris, lacrimal glands,
conjunctiva, eyelids, forehead, nose, nasal and mouth mucosa, teeth, tongue, ear, facial skin
% stick of Trident gum you chew or mastate the gum because you have cotton mouth
Put cotton in eye- rapid blinking - Ans-(V): Trigeminal
lateral eye movement
You want a 6 pack of ABS.. When you see someone with a 6 pack you look from side to side - Ans-(VI):
Abducens
- Ans2x2=4
2x3=6 - Ans-Cranial Tests related to eyes
7 holes in your face
2-eyes, 2-ears, 2 nostrils and 1 mouth= 7
Facial expressions (motor)
Tears and Saliva (motor)
Taste: Anterior 2/3 of tongue (sensory) - Ans-Cranial Nerve VII Facial
Weber and Rinne & whisper tests - Ans-Cranial Nerve VIII Acoustic
Gloss= lip gloss
Pharyngeal= pharynx, mouth throat
Gross= Gag
Gag reflex, Swallow and Taste discrimination - Ans-Cranial Nerve IX Glossopharyngeal [Show Less]